RRH, UR bring health care to the homeless
by: Gino Fanelli
When the term medical innovation is brought up, it conjures images of groundbreaking medical technology, cures for illnesses through extensive experimentation and, ultimately, a benefit for all of humankind.
But in a place like Rochester, which has access to some of the highest level of care in the nation, there is a third kind of innovation: finding a way to bring that care to the people who need it the most and are too often left out of the system.
That’s exactly what Rochester Regional Health and the University of Rochester are doing; RRH through its Mobile Medical units, and UR via its Street Medicine program.
They’re two very different forms of outreach. RRH puts a dental practice and primary care practice on wheels—a modified van traveling to key areas to offer care. No payment, no insurance, no questions asked. UR’s Street Medicine Team is made up of medical students popping up at shelters three times a week.
On a frigid February afternoon, the RRH dental unit parks itself on the street outside a north side Volunteers of America Shelter. It’s a modest setup; a single dental chair situated in the back portion of the van and the mid-portion converted to a sort of waiting room. Put into commission in 2011, it’s the second medical unit since the program’s inception in 1998 and a move up from a rundown truck used in the early days of the program.
“Our philosophy with this program has always been to bring care to the homeless, rather than have them come to us,” said Carlos Swanger, medical director for the Mobile Medical unit and a 20-year veteran of program. “We do go to some shelters directly, without the unit. It’s sometimes easier that way. You have more space inside to provide care. But sometimes we don’t have that access, we don’t have that space, and that’s where the mobile unit comes in.”
There’s no payment required to access the van. No need to call ahead, no need for insurance, just come in and you’ll be treated. But that part can be tricky. Many homeless, as both teams are quick to point out, are inherently fearful of the medical system.
“I have one patient who comes to the door every time, and he’ll just say ‘hello,’” said April Taylor, dental assistant. “I keep wanting him to come on the bus, and I keep wanting him to come inside, but he just comes back and says hello. That’s my goal now, to get him on the bus and get him dental.”
The sentiment is echoed by the URMC students. They are even less equipped, and do not have the means to provide direct medical care. They can take looks, make suggestions and coordinate access to care. But they are also tasked with a sometimes insurmountable job; to break the barrier between the homeless and medical care. Armed with the most basic of medical supplies and a van whose every key turn is a roll of the dice, the fully donation-supported team heads to House of Mercy on a snowy Wednesday evening. Their goal, first and foremost, is to talk.
“We’re there mostly to interact, to be a friendly face,” said Michael Healey, a second year medical student and student director of the program. “We can bring a flu shot, and look to see if there’s something wrong, but mostly, we just try to talk.”
It’s a difficult issue, as volunteer and second-year medical student Stephen Hassig was quick to explain.